Healthcare Provider Details

I. General information

NPI: 1609634161
Provider Name (Legal Business Name): PAMELA CHO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2024
Last Update Date: 03/11/2024
Certification Date: 03/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

359 TYRELLA AVE APT D
MOUNTAIN VIEW CA
94043-3854
US

IV. Provider business mailing address

359 TYRELLA AVE APT D
MOUNTAIN VIEW CA
94043-3854
US

V. Phone/Fax

Practice location:
  • Phone: 916-778-7259
  • Fax:
Mailing address:
  • Phone: 916-778-7259
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: